Clinical application of a three-dimensional reconstruction technique for complex liver cancer resection
Clinical application of a three-dimensional reconstruction technique for complex liver cancer resection
复制标题
三维重建技术在复杂肝癌切除中的临床应用
DOI：
10.1007/s00464-021-08636-2
复制
发表时间：
2021-09-15
影响因子：
3.1
通讯作者：
Lei, Jun
中科院分区：
文献类型：
--
作者：
Sheng, Weiwei;Yuan, Chendong;Lei, Jun
目的探讨三维可视化技术在复杂肝癌切除术中的应用价值。方法回顾性分析2014年1月至2019年6月在我院行复杂性肝癌切除术的105例患者的临床病理资料。观察指标包括一般人口学信息、手术时间、术中出血量、输血量、术后肝功能、并发症发生率、住院时间和住院死亡率。结果与复杂性肝癌对照组相比，（257.1 +/- 63.4 min vs [vs] 326.6 +/- 78.3 min; P < 0.001），术中失血量（256.4 +/- 159.1 mL vs 436.1 +/- 177.3 mL; P < 0.001），输血量复杂性肝癌重建组中的平均血流量（213.3 +/- 185.2 mL vs 401.6 +/- 211.2 mL; P < 0.001）和住院时间（9.7 +/- 3.1天vs 11.9 +/- 3.3天; P = 0.001）显著缩短。尽管两组的术后总并发症发生率无统计学差异，但重建组的严重术后并发症发生率显著低于对照组（分别为3/54 [5.6%] vs 10/51 [19.6%]; P = 0.038）。关于实验室检查，复杂性肝癌重建组的肝功能恢复时间短于复杂性肝癌对照组。结论三维可视化技术的应用对复杂肝癌肝切除术后制定精细、个体化的手术策略具有重要影响，可降低围手术期风险。
Objective To explore the utility of three-dimensional (3D) visualization technology in liver resection for patients with complex liver cancer. Methods In this retrospective cohort study, we collected and analyzed clinic pathological data from 105 patients who underwent complicated liver cancer resection at the authors' unit between January 2014 and June 2019. Observation indicators included general demographic information, operative time, intraoperative blood loss, blood transfusion volume, postoperative liver function, complication rate, hospital stay, and in-hospital mortality. Results Compared with the complex liver cancer control group, operative time (257.1 +/- 63.4 min versus [vs] 326.6 +/- 78.3 min; P < 0.001), intraoperative blood loss (256.4 +/- 159.1 mL vs 436.1 +/- 177.3 mL; P < 0.001), blood transfusion volume (213.3 +/- 185.2 mL vs 401.6 +/- 211.2 mL; P < 0.001), and length of hospital stay (9.7 +/- 3.1 days vs 11.9 +/- 3.3 days; P = 0.001) were significantly reduced in the complex liver cancer reconstruction group. Although there was no statistical difference in total postoperative complication rate between the two groups, the incidence of serious postoperative complications in the reconstruction group was significantly lower than that in the control group (3/54 [5.6%] vs 10/51 [19.6%], respectively; P = 0.038). Regarding laboratory investigations, the time to recovery of liver function in the complex liver cancer reconstruction group was shorter than that in the complex liver cancer control group. Conclusion The use of 3D visualization technology was highly influential in formulating meticulous, individualized surgical strategies for complex liver cancer liver resection with safety and reduced perioperative risk.